A dissertation submitted to the School of Public Health College of Health Sciences, Makerere University In partial fulfillment of the requirement of the award of the degree of Master of Health Services Research

en_US

dc.description.abstract

Abstract
Introduction: Pregnant and breastfeeding women living with HIV have a high risk of transmitting HIV to their babies during pregnancy, labor/delivery, and postpartum through breastfeeding. With the provision of specific PMTCT services like HIV counseling and testing (HCT), early provision of ART to HIV positive pregnant and breastfeeding women and ARV prophylaxis to HIV exposed infants and infant feeding counseling, the risk of MTCT is estimated to reduce to less than 2% in non-breastfeeding populations and less than 5% in breastfeeding populations.
Objective: To assess the quality of prevention of mother-to-child transmission of HIV services at government health facilities in Soroti district to inform quality improvement programs.
Methods: This was a descriptive cross-sectional study using quantitative data collection methods conducted at 17 government health facilities in Soroti district which were selected both purposively and randomly. Data was collected using assessment tool developed by family health international institute for assessing quality of PMTCT services. Data collected were entered to a pre-designed data screen on access and thereafter exported to excel for cleaning. The cleaned data was imported to STATA 12.0 for descriptive analysis to generate frequencies, percentages and graphs. Composite measure analysis was performed to measure the quality of PMTCT services.
Results: Seventeen (17) government health facilities were assessed, majority (76%) were rural. Health workers providing PMTCT services were mainly midwives and nurses (60%). The health workers providing PMTCT services were all trained in PMTCT service areas. PMTCT guidelines were not readily available at the health facilities. The quality of PMTCT services provided to pregnant and breastfeeding women and their infants was low (53%) at health center II facilities, high (81%) at HCIII facilities, and (73%) at both HCV facilities and the regional referral hospital. Quality of PMTCT services was also low (66%) at the rural health facilities, high (82%) at semi-urban facilities and (73%) at urban health facilities. Overall the quality of PMTCT services was low (68%) at the health facilities that were studied.
Conclusion: On average, the overall quality of PMTCT of HIV services offered to pregnant and breastfeeding women and their infants at the government health facilities studied is poor. But then in other spheres, the quality of PMTCT services was good at higher level health facilities, semi-urban and urban health facilities. To improve the quality of PMTCT services provided to pregnant women, breastfeeding women and their infants at the government health facilities, there is need for the district health management and PMTCT focal personnel to ensure availability and use of PMTCT guidelines and sufficient supplies of recommended PMTCT commodities at all health facility levels in the district.

en_US

dc.description.sponsorship

COHRE program

en_US

dc.language.iso

en

en_US

dc.publisher

Makerere University

en_US

dc.subject

HIV Services

en_US

dc.subject

Soroti District

en_US

dc.subject

Pregnant women

en_US

dc.subject

Breastfeeding women

en_US

dc.subject

HIV/AIDS

en_US

dc.subject

ART

en_US

dc.subject

PMTCT

en_US

dc.title

Quality of prevention of mother-to-child transmission of HIV services in Soroti District, Uganda